Offset Catheter Securement Device With Removable Retention Member

ABSTRACT

A catheter securement device adapted to be adhesively mounted to the skin of a patient to secure a catheter in place, the device having a flexible, thin, sheet-like base member with a distal edge and a midportion, and a releasable, flexible, thin, sheet-like retention member. The retention member may include a first releasable end, a second releasable end, a proximal edge, and a distal edge. The distal edge of the retention member is offset from the distal edge of the base member to define an uplift focus area in the midportion of the base member, such that upward pull on the catheter is transferred to the midportion of the base member to preclude the base member from being peeled from the patient&#39;s skin. The retention member may be releasably attached to the base member using a hook-and-loop fastener impregnated with adhesive.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation-in-part and claims the benefit ofpriority of U.S. Non-provisional patent application Ser. No. 15/174,425,filed on Jun. 6, 2016 and titled Offset Catheter Securement Device, andU.S. Non-provisional patent application Ser. No. 14/209,113, filed onMar. 13, 2014, and issued as U.S. Pat. No. 9,358,366 on Jun. 7, 2016 andtitled Offset Catheter Securement Device, the entire contents of whichare hereby expressly incorporated by reference into the presentapplication.

BACKGROUND OF THE INVENTION

This invention relates generally to the field of medical devicesreferred to as catheter securement devices, a catheter being definedherein to include or comprise a small diameter, flexible tithe that isinserted through a person's skin and into a vein to deliver or removefluids such as blood, saline solutions, medications, etc., and oftencomprising a catheter hub or housing acting as a coupling member suchthat multiple distal tubes may be in fluid communication with the singletube leading from the insertion site. The catheter housing may also beutilized in order to provide a larger body for easier securement even ifa single distal conduit tube is present. A catheter securement devicetypically comprises a flexible sheet member adhesively adhered to thepatient's skin, the device having a clamp, flap or strap member torestrain and secure the catheter tubing or a catheter housing in arelatively stable manner such that it is less likely for the catheter tobe accidentally pulled from the patient. The catheter tubing or housingmay be secured within the securement device by pressure, adhesive,recessed members, etc.

Catheter securement devices are typically located a short distance awayfrom the insertion, such that the length of the proximal portion of thecatheter tubing is relatively short. The distal catheter tube or tubesto the contrary may be relatively long. A problem encountered withcatheter securement devices of known design is that any lifting forceapplied intentionally or accidentally to the distal conduit tubes, i.e.,the tubes extending beyond the catheter hub on the opposite side of thecatheter securement device from the proximal conduit tube leading to theinsertion site, may result in undesirable edge uplift force on thecatheter securement device, causing the catheter securement device to bepulled or peeled from the patient's skin with possible dislodgement ofthe catheter.

It is an object of this invention to provide a catheter securementdevice that reduces the likelihood of accidental dislodgement of thecatheter securement device by providing a structural design that shiftsthe upward force focus of any uplift force, created by pulling thedistal tube or tubes in a direction generally perpendicular to the skinsurface, to a location away from the edge and into the mid-portion ofthe catheter securement device, and in particular away from the distaledge and into the mid-portion of the base member adhered to thepatient's skin.

SUMMARY OF THE INVENTION

The invention is a catheter securement device adapted to be adhesivelyadhered to the skin of a patient, the device comprising a flexible,thin, sheet-like base member, a lower adhesive layer being disposed onthe underside of the base member, and a releasable, thin, flexiblesheet, flap or strap catheter retention member removably mounted to theupper side of the base member, the releasable retention member having afirst releasable free end and a second releasable free end. Thesecurement device has a centralized transverse midline located where thecatheter tube or housing is positioned during use, the tube or housingbeing aligned such that the transverse midline of the base member andthe retention members are generally vertically aligned with the axisdefined by the catheter. A releasable fastening mechanism is provided,such as a pressure-sensitive adhesive, a hook-and-loop mechanism, ahook-and-loop fastener that is impregnated with adhesive, or the like,in order to securely fasten the retention member onto the base memberonce positioned across the catheter to preclude the catheter fromundesired movement. The retention member and base member are arrangedsuch that the retention member overlays the base member in an offsetmanner such that the distal edge of the retention member on thetransverse midline is located over the midportion of the base member,i.e., the base member extends further in the distal direction than atleast a portion of the retention member.

The base member is preferably structured to have a midline longitudinaldimension greater than its midline transverse dimension, and alsopreferably is provided with a “dog-bone” or “bowtie” configuration suchthat the transverse width of the base member adjacent both sides of thetransverse midline increases progressively away from the transversemidline to a point where the ends of the base member are rounded.Preferably, the retention member is likewise configured, but smalleroverall. The transverse midline width of the retention member is smallerthan the transverse midline width of the base member and the retentionmember is attached in offset manner relative to the base member, suchthat the distal edge of the retention member is located in themidportion or interior of the base member along the transverse midline.This offset defines a center of uplift or an uplift focus area in themidportion of the base member, whereby pulling the distal tubes resultsin a 360-degree spreading or dispersal of the uplift force radiatingthroughout the base member rather than a concentrated edge uplift forceas found in conventional catheter securement devices.

While the “dog bone” configuration has been found to be beneficial inproperly dispersing the upward forces, the device may have varyingconfigurations for the base and retention members as long as the distaledge of the retention member at the transverse midline is located offsetfrom the distal edge of the base member such that the uplift center islocated within the midportion of the base member such that force isspread radially about the base member. In this manner, any uplift forceapplied to the distal tubes results in a “tenting” or “coning” effectrather than a peeling effect on the base member, thereby greatlyincreasing the sustainable pull force before separation from thepatient's skin occurs.

Alternatively summarized, the invention is a catheter securement deviceadapted to be adhesively mounted to the skin of a patient to secure acatheter comprising a distal tube member, the device comprising aflexible, thin, sheet-like base member comprising a proximal edge, adistal edge and a midportion; a releasable, flexible, thin, sheet-likeretention member comprising a first releasable end, a second releasableend, a proximal edge and a curved distal edge, where both of thereleasable ends are releasably attached to the base member; wherein thecurved distal edge of the retention member is offset from the distaledge of the base member such that the distal edge of the retentionmember defines an uplift focus area located in the middle 50% of themidportion of the base member. The device may further comprise atransverse midline, wherein the distal edge of the retention member isoffset from the distal edge of the base member at the transversemidline, and wherein the transverse midline is laterally centered on thebase member, and/or wherein the retention member is smaller than thebase member and wherein the base member and the retention member aredog-bone shaped.

Alternatively still, the invention may be characterized as thecombination of a catheter securement device adapted to be adhesivelymounted to the skin of a patient and a catheter comprising a distal tubemember, the combination comprising a flexible, thin, sheet-like basemember comprising a proximal edge, a distal edge and a midportion; areleasable, flexible, thin, sheet-like retention member comprising afirst releasable end, a second releasable end, a proximal edge and adistal edge, where both of the releasable ends releasably attach to thebase member, wherein the retention member is releasably securable acrossthe catheter when the catheter is disposed on the base member such thata portion of the distal edge of the retention member extends across thedistal tube member, the portion of the distal edge of the retentionmember being offset from the distal edge of the base member; wherein theportion of the distal edge of the retention member extending across thedistal tube member is offset from the distal edge of the base member,whereby the distal tube members are restrained by the portion of thedistal edge of the distal tube member when upward force is applied tothe distal tube members such that an uplift focus area is defined by theportion of the distal end of retention member, the uplift focus arebeing located in the midportion of the base member. The combination maybe characterized such that the distal edge of the retention member iscurved, the retention member is smaller than the base member, the basemember and the retention member are dog-bone shaped, wherein thelocation of the catheter on the base member defines a transversemidline, and wherein the uplift focus area is located on the transversemidline, and/or wherein the uplift focus area is located in the middle50% of the base member.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a prior art catheter securement device, shown in the openposition.

FIG. 2 is the prior art catheter device of FIG. 1, shown in the closedposition securing a catheter.

FIG. 3 is an embodiment of the offset catheter securement device of thisinvention, shown in the open position.

FIG. 4 is the offset catheter securement device of FIG. 3, shown in theclosed position securing a catheter.

FIG. 5 is a longitudinal view of the prior art catheter device of FIG.2, illustrating the uplift force as concentrated on the edge of the basemember.

FIG. 6 is a longitudinal view of the embodiment of FIG. 4, illustratingthe uplift force as concentrated in the midportion of the base member.

FIG. 7 is a longitudinal view of the prior art catheter device of FIG.2, illustrating the uplift force as concentrated on the edge of the basemember, resulting in a peeling effect such that the base member isseparated from the patient's skin.

FIG. 8 is a longitudinal view of the prior art catheter device of FIG.4, illustrating the uplift force as concentrated in the midportion ofthe base member, resulting in a tenting effect such that the base memberis not separated from the patient's skin.

FIG. 9 is an isometric exploded view of an embodiment of the offsetcatheter securement device of this invention with the retention memberremoved from the base member.

FIG. 10 is a side elevation view of the offset catheter securementdevice of FIG. 9 where the retention member has been attached to thebase member.

FIG. 11 is an isometric exploded view of an embodiment of the offsetcatheter securement device of this invention with the retention memberremoved from the base member.

FIG. 12 is a side elevation view of the offset catheter securementdevice of FIG. 11 where the retention member has been attached to thebase member.

FIG. 13 is an isometric exploded view of an embodiment of the offsetcatheter securement device of this invention with the retention memberremoved from the base member.

FIG. 14 is a side elevation view of the offset catheter securementdevice of FIG. 13 where the retention member has been attached to thebase member.

FIG. 15 is an isometric exploded view of an embodiment of the offsetcatheter securement device of this invention with the retention memberremoved from the base member.

FIG. 16 is a side elevation view of the offset catheter securementdevice of FIG. 15 where the retention member has been attached to thebase member.

DETAILED DESCRIPTION OF THE INVENTION

With reference to the drawings, the invention will now be described indetail with regard for the best mode and the preferred embodiment. Ingeneral, the invention is a catheter securement device that adheres tothe skin of a patient having an epidural catheter or similar smallflexible tube member inserted percutaneously, the securement deviceacting to secure and restrain the catheter tube or housing to prevent orreduce movement near the insertion site or accidental dislodgement ofthe catheter. The securement device in general comprises a flexible,thin, sheet-like base member capable of adhering to the skin of thepatient and a releasable flexible, thin, sheet-like retention member tosecure the catheter onto the main body member, the retention memberbeing releasably mounted onto the base member in an offset manner.

As used herein, the term “catheter” shall include a tube member alone ormultiple tubes in combination with a catheter hub or housing member. Theterm “proximal” shall refer to the direction from the cathetersecurement device toward the catheter insertion site and the term“distal” shall refer to the direction away from the catheter securementdevice opposite from the insertion site, such that for example the term“proximal tube” shall refer to the tube extending between the insertionsite and the securement site and the term “distal tube” shall refer to atube extending from the securement device on the side opposite that ofthe insertion site. The term “proximal edge” shall refer to the side ofthe catheter securement device facing toward the insertion site and theterm “distal edge” shall refer to the side of the securement devicefacing away from the insertion site. The position of the catheterrelative to the securement device when the device is in use shallgenerally define the “axis” or the “axial direction” of the catheter,with the term. “transverse” defining the direction generally parallel tothe axial direction, i.e., the width of the device, and the term“longitudinal” defining the direction perpendicular to the transversedirection. The term “transverse midline” shall define a line locatedgenerally parallel to and in approximate vertical alignment with thecatheter axis when the device is in use, which is preferably located asthe true dimensionally-centered midline of the base member and retentionmember. The terms “midportion” or “interior” shall refer to a locationaway from the outer edges of the base member. The term “uplift focusarea” shall refer to a point or small area where uplift forces resultingfrom pulling a distal tube in the direction perpendicular (i.e.,vertical) to the skin of the patient are initially concentrated on ortransferred to the base member of the catheter securement device.

An exemplary embodiment of prior art catheter securement devices 110 isillustrated in FIGS. 1, 2, 5 and 7, which show a catheter securementdevice 110 comprising a base member 111 and a releasable retentionmember 121. The base member 111 is a flexible, thin, sheet-like member,having an adhesive backing and generally elongated preferably into a“dog bone” configuration with a proximal edge 112 and a distal edge 113,both of which are preferably concave, and two ends 114, preferablyrounded, the base member 111 and retention member 121 being shorter intransverse direction than in the longitudinal direction. As shown inFIGS. 1, 2, 5, and 7, the retention member 121 is a flexible, thin,sheet-like strap or flap member having a fixed end 124 secured to thebase member 111 and a free end 125, also shown in a “dog bone”configuration with a concave proximal edge 122 and distal edge 123.

Also, an optional adhesive layer 154 may be provided as shown on theupper surface of the base member 111 and/or the underside of theretention member to better secure the catheter 130 in place. As shown inthe figures, the catheter 130 is embodied as a housing or hub 131 with aproximal (insertion) tube member 132 and multiple distal (accessoryconnecting) tube members 133. The transverse midline 142 is illustratedas being laterally centered. An uplift focus area 141 occurs at thepoint or area at or near the distal edge 123 of the retention member,depending on the tautness of the retention member 121 relative to thebase member 111, where uplift forces 143 are applied to distal tubemembers 133. Because the transverse width of the base member 111 issubstantially equal with that of the retention member 121, the distaledges 113 and 123 at the transverse midline 142 are aligned. Thisresults in the uplift focus area 141 occurring at or adjacent the distaledge 113 of the base member 111 as well, as shown in FIGS. 2 and 5,thereby leading to lifting of the distal edge 113 when uplift forces 143are applied to the distal tube members 133, as shown in FIG. 7, suchthat a peeling effect is created and the base, member 111 is susceptibleto being peeled from the patient's skin 143.

The invention addresses this problem, as shown in the illustratedembodiment of FIGS. 3, 4, 6 and 8, by providing an improved cathetersecurement device 10 for securing a catheter 30 comprising as shown acatheter housing or hub 31, a proximal tube member 32 and plural distaltube members 33 to a patient's skin 43. As illustrated, the cathetersecurement device 10 is adapted to be adhesively adhered to the skin 43of a patient, the device comprising a thin, flexible, sheet-like basemember 11 with an upper side 16 and an underside 17, a lower adhesivelayer 54 being disposed in known manner on the underside 17 of the basemember 11 to adhere the base member 11 directly to the patient's skin43, and a releasable, thin, flexible, sheet-like catheter retentionmember 21, in the form of a flap or strap, mounted to the upper side 16of the base member 11, the releasable retention member 21 having a fixedend 24 and a releasable free end 25. Alternatively, both ends of theretention member 21 could be releasable affixed to the base member 11 aswill be further described below. Where one of the ends is fixed, thefixed end 24 may be secured to the upper side 16 of the base member 11in suitable known manner, such as by adhesive bonding, stitching, meltbonding, hook-and-loop fastener, or the like. A releasable fasteningmechanism or system 51 is provided, such as a pressure-sensitiveadhesive, a hook-and-loop mechanism, or the like, in order to securelyretain the retention member 21 onto the base member 11 when theretention member 21 is pulled tautly across the catheter 30 to precludethe catheter 30 from undesired movement. As shown in this embodiment,the releasable fastening mechanism 51 is a hook-and-loop fastenercomprising the releasable combination of a hook component 52 and a loopcomponent 53. As discussed above, either or both of the hook component52 and the loop component 53 could be impregnated with adhesive.

The base member 11 comprises a proximal edge 12, a distal edge 13, apair of ends 14 and a transverse midline 42 a (most preferably centeredlaterally). The base member 11 has a perimeter 15 defined by theproximal edge 12, the distal edge 13, and the pair of ends 14. Theretention member 21 comprises a proximal edge 22, a distal edge 23 and atransverse midline 42 b, such that the transverse midlines 42 a and 42 boverlap so as to be generally vertically aligned when the retentionmember 21 is closed over the catheter 30 and secured to the base member11. The retention member 21 also has a perimeter 27 defined by theproximal edge 22, the distal edge 23, the free end 25 and the fixed end24. As can be seen, for instance in FIG. 4, the perimeter 15 of the basemember 11 is greater than perimeter 27 of the retention member 21. Thedistal edge 23 of the retention member 21 is positioned offset from thedistal edge 13 of the base member 11, preferably over the entirelongitudinal length of the securement device 10 but at least in the areacorresponding to the position of the distal tube members 33, i.e., inthe area of the transverse midline 42 defined by the position of thecatheter 30. The transverse midline 42 is located and defined by thelocation of the axis of the catheter hub 31 during use, the securementdevice and catheter hub 31 being positioned such that the transversemidline 42 a of the base member and the transverse midline 42 b of theretention members are generally vertically aligned with the maintransverse midline 42 defined by the position of the catheter hub 31axis when the retention member 21 is fastened across the catheter 30.Preferably, the retention member 21 and base member 11 are sized andarranged such that the smaller retention member 21 overlays the largerbase member 11 in an offset manner such that at least a portion of thedistal edge 23 of the retention member 21 on the transverse midline 42is located over the midportion 28 or interior of the base member 11 andis separated away from the distal edge 13 of the base member 11, suchthat the distal edge 13 of the base member 11 extends farther in thedistal direction than the retention member 21.

The base member 11 is preferably structured to have a midlinelongitudinal dimension greater than its midline transverse dimension,and also preferably is provided with a “dog-bone” or “bowtie”configuration such that the transverse width of the base member 11adjacent both sides of the transverse midline 42 a increasesprogressively away from the transverse midline 42 a to a point where theends 14 of the base member 11 are rounded, thereby producing concaveproximal and distal edges 22/23. However, the shape of the base member11 and the retention member 21 could vary as will further be describedbelow. Preferably, the retention member 21 is likewise configured, butsmaller overall. Other configurations for the perimeter 15 of the basemember 11 and the perimeter 27 of the retention member 21 are alsopossible. Alternatively, for example, a short segment of the distal edge23 of the retention member 21 over and adjacent the transverse midline42 b, i.e., the segment that resides over the distal tube members 33when in use, may be recessed, notched or indented while the remainingportions of the distal edge 23 extend toward or to the distal edge 13 ofthe base member 11.

The location of the distal edge 23 of the retention member 21 in thearea of the transverse midline 42 b defines an uplift focus area 41representing the focus of uplift forces 45 when the distal tube members33 are pulled generally perpendicularly away from the securement device10 and the skin 43 of the patient. The uplift force 45 on the distaltube members 33 is intercepted and restricted by the distal edge 23 ofthe retention member 21, such that the uplift force 45 is transmitteddown to the base member 11 and the patient's skin 43 at this upliftfocus area 41. In prior art devices wherein the distal edge 123 of theretention member 121 is adjacent or overlaps the distal edge 113 of thebase member 111, as shown in FIGS. 5 and 7, the uplift focus area 141 issituated at or adjacent the distal edge 113 of the base member 111. Inthis circumstance, when the distal tube members 133 are pulled upward,the uplift force 143 becomes an edge uplift force 143 concentrated onthe distal edge 113 which produces a peeling effect. If the edge upliftforce 143 exceeds the base member adhesive force, the base member 111will be peeled from the patient's skin 143.

By offsetting the retention member distal edge 23 from the base memberdistal edge 13, the uplift focus area 41 is shifted into the midportion28 or interior of the base member 11, whereby pulling the distal tubemembers 33 results in a 360-degree dispersion of the uplift force 45across and within the base member 11, as shown in FIGS. 6 and 8. Withthis construction, the uplift force 45 produces a tenting or coningeffect on the base member 11 and the underlying skin 43, such that thelikelihood of de-adhesion of the base member 11 is greatly reduced,since a much greater force 45 is required to separate the base member 11away from the skin 43 in the interior of the base member 11 than isrequired to peel the base member 11 from the skin by its edge.

As discussed above, while the “dog bone” configuration has been found toproduce excellent results in practice, the device could have varyingconfigurations for the base member 11 and retention member 21 as long asthe distal edge 23 of the retention member 21 at the transverse midline42 is located offset from the distal edge 13 of the base member 11 suchthat the uplift force area 41 is located within the midportion 28 of thebase member 11 such that uplift force 45 is radially dispersed about themidportion 28 of the base member 11. In this manner, any uplift force 45applied to the distal tube members 33 results in a “tenting” or “coning”effect rather than a peeling effect of the base member 11, therebygreatly increasing the sustainable pull force before separation from thepatient's skin 43 occurs.

Additionally, as shown in FIGS. 9-16, the retention member 21 need notnecessarily have a fixed end. Instead, the base member 11 and theretention member 21 could be two separate pieces that are laterreleasably connected. In this way, the retention member 21 could becompletely removed from the base member 11. The retention member 21having a first releasable end 56 and a second releasable end 58 wouldallow the retention member 21 to be easily and quickly installed to thebase member 11. For instance, as shown in the FIGS. 11 and 12, theretention member 21 could be in the shape of a dog bone. Alternatively,the retention member 21 could be substantially rectangular in shape asshown in FIGS. 14-16. Alternatively still, a second retention member 60could be used with the retention member 21 as shown in FIGS. 9 and 10.For instance, the two retention members 21, 60 may form an X. By usingtwo retention members 21, 60 that overlap one another, the overallstrength of the securement device 10 could be increased. Further still,additional retention members may be included beyond first and secondretention members to improve the strength of the securement device priorto failure. Also, the retention member 21 could extend beyond theperimeter of the base member 11, as seen in FIGS. 15 and 16. Thisextension could result in a grip 62 that would facilitate easy removalof the retention member 21.

The retention member 21 or 60 could be made of bandage material, or theycould also be a piece of adhesive tape. Where the retention member 21 or60 is made of bandage material, the retention member 21 or 60 could beattached to the base member 11 using any attachment mechanism as knownin the art. For instance, a releasable fastening mechanism or system 51is present, as shown comprising a hook component 52 and a loop component53 of a suitable hook-and-loop fastener. Either of these components 52,53 could be impregnated with adhesive to further improve thefunctionality and hold of the components 52, 53. As a result, a layer ofthe catheter securement device 10 could be eliminated while stillmaximizing the functionality of the device.

While particular dimensions may vary, it is preferred that the elementsof the device be configured and sized such that the uplift focus area 41is centered along the transverse midline 42 in the middle 50% of thebase member 11, i.e., for a base member 11 having a two inch width onthe transverse midline 42, the retention member distal edge 23 on thetransverse midline 42 is situated between about one quarter inch toabout three quarter inches from the base member distal edge 13. Morepreferably, the uplift focus area 41 is more centrally located, suchthat for the two inch wide example given above the retention memberdistal edge 23 is situated between about one-quarter inch to about onehalf inch from the base member distal edge 13. The more tightly thecatheter 33 is secured within the catheter securement device 10, i.e.,the more tautly the retention member 21 is secured to the base member11, the closer the true center of the uplift focus area 41 will be tothe distal edge 23 of the retention member 21. For a looser securing,the true center of the uplift focus area 41 will shift slightly awayfrom the distal edge 23.

It is to be understood that equivalents and substitutions to elementsand structures set forth above, which are not intended to be limitingunless necessary for patentability, may be obvious to those of ordinaryskill in the art, and therefore the true scope and definition of theinvention is to be as set forth in the following claims.

What is claimed is:
 1. A catheter securement device adapted to beadhesively mounted to the skin of a patient to secure a cathetercomprising a distal tube member, the device comprising: a flexible,thin, sheet-like base member comprising a proximal edge, a distal edgeand a midportion located between the proximal edge and the distal edgeof the base member; a releasable, flexible, thin, sheet-like retentionmember comprising a proximal edge and a distal edge, the retentionmember substantially parallel to the base member when attached to thebase member; the distal edge of the retention member located adjacent tothe midportion of the base member when the releasable end is attached tothe base member; wherein the distal edge of the retention member islaterally offset from the distal edge of the base member.
 2. The deviceof claim 1, further comprising a transverse midline, wherein the distaledge of the retention member is offset from the distal edge of the basemember at the transverse midline.
 3. The device of claim 2, wherein thetransverse midline is laterally centered on the base member.
 4. Thedevice of claim 1, further comprising: one of a hook-and-loop fastenermounted to the base member; the other of a hook-and-loop fastenermounted to of the retention member; and an adhesive overlaying thehook-and-loop fastener.
 5. The device of claim 1, wherein the retentionmember is substantially rectangular in shape.
 6. The device of claim 1,further comprising a first releasable end and a second releasable end,the second releasable end of the retention member extending beyond afirst end of the base member.
 7. The device of claim 6, wherein thesecond releasable end of the retention member forms a grip.
 8. Thedevice of claim 1, further comprising a second retention member, whereinthe first retention member and the second retention member overlap oneanother.
 9. The device of claim 1, wherein said retention member isconfigured to form an uplift focus area located at said midportion ofthe base member when upward force is applied to said distal tube membersuch that said base member tents up when the upward force is applied tothe distal tube member
 10. The device of claim 9, wherein the upliftfocus area is located in the middle 50% of the base member.
 11. Thedevice of claim 10, wherein the uplift focus area is located in themidportion of the base member along a transverse midline of the basemember.
 12. A combination of a catheter securement device adapted to beadhesively mounted to the skin of a patient and a catheter comprising adistal tube member, the combination comprising: a flexible, thin,sheet-like base member comprising a proximal edge, a distal edge and amidportion; a releasable, flexible, thin, sheet-like retention membercomprising a first releasable end, a second releasable end, a proximaledge, and a distal edge, wherein the retention member is releasablysecurable across the catheter when the catheter is disposed on the basemember such that a portion of the distal edge of the retention memberextends across the distal tube member, the portion of the distal edge ofthe retention member being laterally offset from the distal edge of thebase member along a horizontal axis extending through a transversemidline of the base member; wherein the portion of the distal edge ofthe retention member extending across the distal tube member is offsetfrom the distal edge of the base member, whereby the distal tube memberis restrained by the portion of the distal edge.
 13. The combination ofclaim 12, further comprising: one of a hook-and-loop fastener mounted tothe upper side of the base member; the other of a hook-and-loop fastenermounted to the underside of the retention member; and an adhesiveoverlaying the hook-and-loop fastener.
 14. The combination of claim 12,wherein the base member and the retention member are dog-bone shaped.15. The combination of claim 12, wherein the retention member issubstantially rectangular in shape.
 16. The combination of claim 12,further comprising a second retention member, wherein the firstretention member and the second retention member overlap one another.17. The combination of claim 12, wherein the retention member is smallerthan the base member.
 18. A catheter securement device removably adheredto a patient's skin to secure a catheter housing with a plurality ofdistal tube members comprising; a base member defining a perimeter withan upper side and an underside, the base member comprising a distal edgeopposite a proximal edge and a first end opposite a second end; aretention member defining a perimeter with an underside and a distaledge opposite a proximal edge releasably attached to the upper side ofthe base member, the distal edge of the retention member laterallyoffset from the distal edge of the base member along the length of thedistal edge of the retention member and the proximal edge of theretention member flush with the proximal edge of the base member alongthe length of the proximal edge of the retention member.
 19. Thecatheter securement device of claim 18, wherein the perimeter of theretention member is smaller than the perimeter of the base member. 20.The catheter securement device of claim 18, further comprising: one of ahook-and-loop fastener mounted to the upper side of the base member; theother of a hook-and-loop fastener mounted to the underside of theretention member; and an adhesive overlaying the hook-and-loop fastener.